Doctoring in a strange country

Abstract

Objective: There is a critical shortage of health workforce in rural Australia. Solutions to the problem include recruitment of overseas trained and qualified health professionals. In the Central Wheatbelt catchments, there is a heavy reliance on International Medical Graduates (IMGs) for general practice coverage. IMGs experience significant barriers including effective GP-patient communication. The aim of this study was to identify IMG patient communication issues as a means of addressing some of the barriers. Design, participants and setting: Concurrent QUAN+QUAL study was conducted across Central Wheatbelt. The quantitative phase comprised survey of Australia-trained General Practitioners’ (AGPs) and IMGs’ patients. The qualitative phase involves semi-structured interviews with AGPs and IMGs. Ethics approval was granted from University of Western Australia Human Research Ethics Committee. Results: Patients are generally receptive to IMGs for alleviating medical shortage in isolated rural communities. Nonetheless, communication barriers exist between both IMG-patient and IMG-AGP. These included cultural differences in communication style, accents of IMGs, and the use of Australian vernacular. An enabler was the Wheatbelt-NPS case study nights involving both IMGs and AGPs. The routine case study nights enabled informal mentoring of new IMGs by more experienced general practitioners (GPs) and NPS Facilitator; facilitated networking between AGPs and IMGs, and the follow-up visit by NPS Facilitator provided feedback to individual IMG in an appropriate and sensitive way. Other proposed solutions identified include orientation workshops for IMGs on understanding rural psyche and crosscultural differences prior to commencing general practice work. Conclusion: IMGs are not a homogenous group. Programs for IMGs need to be tailored to local needs.